Provider Demographics
NPI:1386478188
Name:SANCHEZ, LIANNA NICOLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LIANNA
Middle Name:NICOLE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 VIA ALICANTE UNIT G
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2451
Mailing Address - Country:US
Mailing Address - Phone:760-978-9098
Mailing Address - Fax:
Practice Address - Street 1:13223 BLACK MOUNTAIN RD # 1508
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2698
Practice Address - Country:US
Practice Address - Phone:760-978-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist